What the U S A as the World's Oldest and Most Successful Democracy Can Learn From Others~~ HOW TO FIX HEALTHCARE~~

Republicans, at least rhetorically, claim to value federalism and to believe that the states can function as "laboratories of democracy"-- places where policy experimentation can take place. Through this process, flawed policies are exposed and voted down and newer, better policies are given a chance to prove themselves. Over time, the policies that prove to be the best are adopted by other states.

For some reason, though, the only laboratories of democracy that matter to Republicans are those located within the United States.

This is especially true when it comes to health care. The United States is not the only industrialized democracy in the world. We are, however, the only one that does not guarantee basic health care to all of its citizens. When Democrats propose relatively mild reforms to our current dysfunctional system, such as creating a public insurance option, Republicans flip out and suggest that doing so will result in some sort of socialized health care dystopia.

But we don't need to travel into some hypothetical world to understand what universal health care looks like. There are literally dozens of countries in the real world that have functioning universal health care systems. Indeed, the verdict of the world's laboratories of democracy is pretty clear. Virtually all of them produce better health outcomes at less cost while covering everyone. We're the outliers. We're the laboratory that's stubbornly refusing to acknowledge that its experiment has failed.

To adopt the Republican position on health care requires believing that every other country in the world is wrong, that their policy experts are misguided and their citizens confused. Indeed it requires believing that the American people themselves are wrong, that despite endless opinion polls to the contrary, people in this country really love the system we have.

You would think that, at some point, these lovers of federalism would ask themselves why it is that no country in the world currently has (or has any plans to adopt) the kind of health care system they're clamoring for. After all, if the ideal health care system is one in which the government plays the least active role and lets the free market work its magic, you would think that some country would have already tried that by now. Such a policy is, after all, much easier to execute and to fund. It's infinitely less complex and requires much less government spending, so you would think that at least some group of lawmakers somewhere would have given the "do nothing" approach a shot. And if the results were as great as the Republicans claim, by now most countries would be following such a system.

Of course, the reason no one follows such a system is because it doesn't work. As economists have understood for many decades, markets don't work very well in the area of health care, at least if the goal is producing a world in which most people can afford care. Indeed, the reason we have a patchwork system of health care in this country is precisely because the market doesn't work and the government has been forced to step in and remedy its most glaring failures. Under a free market system, most elderly people are priced out of the market (hence the need for Medicare). Under a free market system, the poor can't afford health care (hence the need for Medicaid). Under a free market system, children of those without insurance have no access to health care (hence the need for S-CHIP). Every health insurance regulation or government program currently on the books was passed in order to address a significant failure of the market.

Other countries have confronted the exact same issues, but instead of trying to solve these problems piecemeal, they have opted for a comprehensive approach. In an effort to discredit the far better approaches taken by other countries, Republicans like to cherry-pick stories of people who were denied treatment or had to wait for treatment under a universal system (while ignoring the very same kinds of stories in our country). But here are some numbers they ignore:

The number of people in other industrialized democracies who go bankrupt as a result of medical bills = 0

The number of people in other industrialized democracies who lack access to routine medical care = 0

The number of people in other industrialized democracies who feel trapped at their jobs for fear of losing their (or their family's) health insurance = 0.

That last number is particularly galling given conservative reverence for entrepreneurism. Though it's difficult to quantify, I would bet that our dysfunctional health care system, more than any other factor, discourages entrepreneurial risk-taking in this country. Which makes all this talk about free markets all the more absurd.

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